Evidence map›Paper›PMID 41588719›Full record

Trial reportMedical education online2026

Comparison of cognitive workload between very short answer questions and multiple-choice questions: an eye-tracking experiment.

Maria Gabriela Carneiro Queiroz, Francisco Carlos Specian Junior, Pedro Tadao Hamamoto Filho, Thiago M Santos, Stefan K Schauber, Andrea M Woltman, Dario Cecilio-Fernandes

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in Medical education online, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Maria Gabriela Carneiro QueirozSchool of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.ORCID 0009-0008-8964-0499
Francisco Carlos Specian JuniorSchool of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.
Pedro Tadao Hamamoto FilhoDepartament of Neurosciences and Mental Health, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu, São Paulo, Brazil.ORCID 0000-0001-6436-9307
Thiago M SantosSchool of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.ORCID 0000-0002-4686-3122
Stefan K SchauberFaculty of Medicine, Section for Health Professions Education (HELP) and Centre for Educational Measurement (CEMO/CREATE), Faculty of Educational Sciences, University of Oslo, Oslo, Norway.ORCID 0000-0002-1832-2732
Andrea M WoltmanInstitute of Medical Education Research Rotterdam (iMERR), Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.ORCID 0000-0001-9904-6751
Dario Cecilio-FernandesSchool of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil.ORCID 0000-0002-8746-1680

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Very short answer questions (VSAQs) have gained attention for their superior psychometric properties compared to multiple-choice questions (MCQs). While VSAQs require knowledge recall, MCQs primarily involve knowledge recognition. This difference in cognitive processes may lead to varying cognitive workloads, defined as the amount of mental processing in working memory. Previous studies have not demonstrated consistent differences, likely due to reliance on self-reported measures. Eye tracking provides objective, process-level indicators of cognitive workload. This study investigated whether answering VSAQs requires a higher cognitive workload than answering MCQs. In a within-subject randomized crossover experiment, sixth-year medical students answered both VSAQs and MCQs. Cognitive workload was measured using screen-based eye tracking, focusing on the number of fixations and revisitations as objective indicators of mental effort. Data were analyzed using mixed-effects models. Thirty-four medical students participated, yielding 1,326 observations, which is the multiplication of the number of students by the number of questions (39 questions). Mixed-effects models showed a significant effect of question type on both workload indicators: VSAQs elicited more fixations and revisitations than MCQs (β_std = 0.30-0.39,

Indexed as

CognitionEducational MeasurementEye-Tracking TechnologyStudents, MedicalWorkloadCross-Over StudiesEducation, Medical, UndergraduateFemaleHumansMaleMemory, Short-TermPsychometricsYoung Adultcognitive workloadEducational assessmenteye trackingmedical educationvery short answer questions

Identifiers

PMID41588719
PMCPMC12849799

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.